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Quantitative Antibiogram as a Typing Method for the Prospective Epidemiological Surveillance and Control of MRSA Comparison with Molecular Typing

Published online by Cambridge University Press:  02 January 2015

Dominique S. Blanc ,
Christiane Petignat ,
Philippe Moreillon ,
Aline Wenger ,
Jacques Bille  and
Patrick Francioli
Dominique S. Blanc*
Affiliation:
Division of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Christiane Petignat
Affiliation:
Division of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Philippe Moreillon
Affiliation:
Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Aline Wenger
Affiliation:
Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Jacques Bille
Affiliation:
Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Patrick Francioli
Affiliation:
Division of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
*
Division automnome de médecine préventive hospitalière, Centre Hospitalier Univertitaire Vaudois, CH-1011 Lausanne, Switzerland
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Abstract

Objective:

Evaluation of the quantitative antibiogram as an epidemiological tool for the prospective typing of methicillin-resistant Staphylococcus aureus (MRSA), and comparison with ribotyping.

Methods:

The method is based on the multivariate analysis of inhibition zone diameters of antibiotics in disk diffusion tests. Five antibiotics were used (erythromycin, clindamycin, cotrimoxazole, gentamicin, and ciprofloxacin). Ribotyping was performed using seven restriction enzymes (EcoRV, HindIII, KpnI, PstI, EcoRI, SfuI, and BamHI).

Setting:

1,000-bed tertiary university medical center.

Results:

During a 1-year period, 31 patients were found to be infected or colonized with MRSA. Cluster analysis of antibiogram data showed nine distinct antibiotypes. Four antibiotypes were isolated from multiple patients (2, 4, 7, and 13, respectively). Five additional antibiotypes were isolated from the remaining five patients. When analyzed with respect to the epidemiological data, the method was found to be equivalent to ribotyping.

Among 206 staff members who were screened, six were carriers of MRSA. Both typing methods identified concordant of MRSA types in staff members and in the patients under their care.

Conclusions:

The quantitative antibiogram was found to be equivalent to ribotyping as an epidemiological tool for typing of MRSA in our setting. Thus, this simple, rapid, and readily available method appears to be suitable for the prospective surveillance and control of MRSA for hospitals that do not have molecular typing facilities and in which MRSA isolates are not uniformly resistant or susceptible to the antibiotics tested.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 10 , October 1996 , pp. 654 - 659
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996 

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References

1. Blumberg, HM, Rimland, D, Kiehlbauch, JA, Terry, PM, Wachsmuth, IK. Epidemiologic typing of Staphylococcus aureus by DNA restriction fragment length polymorphisms of rRNA genes: elucidation of the clonal nature of a group of bacterio-phage-nontypeable, ciprofloxacin-resistant, methicillin-suscep-tible S aureus isolates. J Clin Microbiol 1992;30:362–369.CrossRefGoogle ScholarPubMed
2. Costas, M, Cookson, BD, Talsania, HG, Owen, RJ. Numerical analysis of electrophoretic protein patterns of methicillin-resistant strains of Staphylococcus aureus . J Clin Microbiol 1989;27:2574–2581.10.1128/jcm.27.11.2574-2581.1989CrossRefGoogle ScholarPubMed
3. Nicolle, L, Bialkowska-Hobrzanska, H, Romance, L, Harry, VS, Parker, S. Clonal diversity of methicillin-resistant Staphylococcus aureus in an acute-care institution. Infect Control Hosp Epidemiol 1992;13:33–37.CrossRefGoogle Scholar
4. Preheim, L, Pitcher, D, Owen, R, Cookson, B. Typing of methicillin resistant and susceptible Staphylococcus aureus strains by ribosomal RNA gene restriction patterns using a biotinylated probe. Eur J Clin Microbiol Infect Dis 1991;10:428–436.CrossRefGoogle ScholarPubMed
5. Trilla, A, Nettleman, MD, Hollis, RJ, Fredrickson, M, Wenzel, RP, Pfaller, MA. Restriction endonuclease analysis of plasmid DNA from methicillin-resistant Staphylococcus aureus: clinical application over a three-year period. Infect Control Hosp Epidemiol 1993;14:29–35.10.1086/646627CrossRefGoogle Scholar
6. Wei, MQ, Wang, F, Grubb, WB. Use of contour-clamped homogeneous electric field (CHEF) electrophoresis to type methicillin-resistant Staphylococcus aureus . J Med Microbiol 1992;36:172–176.CrossRefGoogle ScholarPubMed
7. Giacca, M, Menzo, S, Trojan, S, Monti-Bragadin, C. Cluster analysis of antibiotic susceptibility patterns of clinical isolates as a tool in nosocomial infection surveillance. Eur J Epidemiol 1987;3:155–163.CrossRefGoogle ScholarPubMed
8. Blanc, DS, Lugeon, L, Wenger, A, Siegrist, HH, Francioli, P. Quantitative antibiogram typing using inhibition zone diameters compared with ribotyping for epidemiological typing of methicillin-resistant Staphylococcus aureus . J Clin Microbiol 1994;32:2505–2509.10.1128/jcm.32.10.2505-2509.1994CrossRefGoogle ScholarPubMed
9. Lugeon, C, Blanc, DS, Wenger, A, Francioli, P. Molecular epidemiology of methicillin-resistant Staphylococcus aureus at a low incidence hospital over a 4-year period. Infect Control Hosp Epidemiol 1995;16:260–267.CrossRefGoogle Scholar
10. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing. M2-A4. Villanova, PA: NCCLS; 1991.Google Scholar
11. Blanc, DS, Siegrist, HH, Sahli, R, Francioli, P. Ribotyping of Pseudomonas aeruginosa: discriminatory power and usefulness as a tool for epidemiological studies. J Clin Microbiol 1993;31:71–77.CrossRefGoogle ScholarPubMed
12. Struelens, MJ, Deplano, A, Godard, C, Maes, N, Serruys, E. Epidemiological typing and delineation of genetic relatedness of methicillin-resistant Staphylococcus aureus by macrorestriction analysis of genomic DNA by using pulsed-field electrophoresis. J Clin Microbiol 1992;30:2599–2605.CrossRefGoogle Scholar
13. Tenover, FC, Arbeit, R, Archer, G, et al. Comparison of traditional and molecular methods of typing isolates of Staphylococcus aureus . J Clin Microbiol 1994;32:407–415.10.1128/jcm.32.2.407-415.1994CrossRefGoogle ScholarPubMed